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The effects of in utero exposure to teratogens on organ size: a prospective paediatric study

Published online by Cambridge University Press:  17 November 2020

J. J. A. De Smidt Open the ORCID record for J. J. A. De Smidt [Opens in a new window] ,
H. J. Odendaal ,
D. G. Nel ,
H. Nolan ,
C. Du Plessis ,
L. T. Brink  and
A. Oelofse
J. J. A. De Smidt*
Affiliation:
Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa
H. J. Odendaal
Affiliation:
Department of Obstetrics and Gynaecology, Stellenbosch University, Stellenbosch, South Africa
D. G. Nel
Affiliation:
Department of Statistics and Actuarial Science, Stellenbosch University, Stellenbosch, South Africa
H. Nolan
Affiliation:
Department of Obstetrics and Gynaecology, Stellenbosch University, Stellenbosch, South Africa
C. Du Plessis
Affiliation:
Department of Obstetrics and Gynaecology, Stellenbosch University, Stellenbosch, South Africa
L. T. Brink
Affiliation:
Department of Obstetrics and Gynaecology, Stellenbosch University, Stellenbosch, South Africa
A. Oelofse
Affiliation:
Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa
*
Address for correspondence: J. J. A. De Smidt, University of the Western Cape, Private BagX17, Bellville, Cape Town7535, South Africa. Email: jjdesmidt@gmail.com
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Abstract

In low-income countries, prospective data on combined effects of in utero teratogen exposure are lacking and necessitates new research. The aim of the present study was to explore the effect of in utero teratogen exposure on the size of the kidneys and pancreas 5 years after birth in a low-income paediatric population. Data was collected from 500 mother–child pairs from a low-income setting. Anthropometric measurements included body weight, (BW) body height, mid-upper arm and waist circumference (WC). Clinical measurements included blood pressure (BP), mean arterial pressure and heart rate. Ultrasound measurements included pancreas, and kidney measurements at age 5 years. The main outcome of interest was the effect of maternal smoking and alcohol consumption on ultrasound measurements of organ size at age 5 years. Left and right kidney length measurements were significantly lower in smoking exposed children compared to controls (p = 0.04 and p = 0.03). Pancreas body measurements were significantly lower in smoking exposed children (p = 0.04). Multiple regression analyses were used to examine the associations between the independent variables (IDVs), maternal age, body mass index (BMI), mid-upper arm circumference (MUAC) and BW of the child, on the dependent variables (DVs) kidney lengths and kidney volumes. Also, the association between in utero exposure to alcohol and nicotine and pancreas size. WC was strongest (r = 0.28; p < 0.01) associated with pancreas head [F (4, 454) = 13.44; R2 = 0.11; p < 0.01] and tail (r = 0.30; p < 0.01) measurements at age 5 years, with in utero exposure, sex of the child and BMI as covariates. Kidney length and pancreas body measurements are affected by in utero exposure to nicotine at age 5 years and might contribute to cardiometabolic risk in later life. Also, findings from this study report on ultrasound reference values for kidney and pancreas measurements of children at age 5 years from a low-income setting.

Keywords

Alcoholbody mass indexintrauterine teratogen exposurekidney sizelow birth weightlow-income settingnicotinepancreas sizepaediatricswaist circumference
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 12 , Issue 5 , October 2021 , pp. 748 - 757
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Copyright
© The Author(s), 2020. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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